甲状腺乳头状癌患者单侧腺叶切除术后嗓音特点分析

刘海鹰;房居高;孟令照;饶远生;杨帆;王建宏;

1:首都医科大学附属北京安贞医院耳鼻咽喉头颈外科

2:首都医科大学附属北京同仁医院耳鼻咽喉头颈外科

摘要

目的探讨甲状腺乳头状癌患者行单侧腺叶切除术后嗓音变化的特点。方法选取2017年1月～2018年12月因甲状腺乳头状癌行单侧腺叶切除术且无喉神经损伤的患者34例(研究组,男16例,女18例)为研究对象,在术前及术后1周、1个月、3个月行频闪喉镜检查及嗓音声学分析,分析基频(F0)、基频微扰(jitter)、振幅微扰(shimmer)、信噪比(harmonics-to-noise ratio,HNR)、最大发声时间(maximum phonation time,MPT),并进行嗓音障碍指数(voice handicap index,VHI)量表自我评估,比较手术前后结果,并与同期性别、年龄相匹配、无发声障碍的全麻下行慢性中耳炎手术的40例患者(对照组)比较。结果研究组女性患者术后1周VHI评估中,生理(phsical,P)、情感(emotional, E)及总体(total,T)评分均高于术前(P<0.05);术后1个月,E评分仍高于术前(P<0.05);研究组女性术后3个月及男性术后1周、1个月、3个月VHI各项评分与术前比较差异均无统计学意义。与对照组比较,研究组女性患者术前、术后1周及术后1个月MPT值均减小(均P<0.05),术后1周及1个月,F0值均降低(P<0.01,P<0.05);研究组男性患者术后1周MPT、F0值均小于术前(P<0.05)。结论甲状腺乳头状癌患者行单侧腺叶切除术后,即使无喉返及喉上神经损伤,嗓音主客观评估指标也可异常,术后1周时最重,术后3个月时基本恢复正常。

关键词

甲状腺;手术;嗓音

基金项目(Foundation):

作者

刘海鹰;房居高;孟令照;饶远生;杨帆;王建宏;

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